Background: Asymmetric hand‐use is commonly the first clinical signs of unilateral cerebral palsy (CP) in infants, however, there is no assessment available which can detect and measure hand function in infants 3–10 months old. Aim: To describe the development of the Hand Assessment for Infants (HAI), the concept and construct and to report psychometric properties. Method: Test items were developed from literature review, expert groups and from systematic observations of goal‐directed hand/arm actions of infants. Internal scale validity was evaluated by Rasch measurement model analysis of 157 assessments of a clinical convenience sample of infants with a brain damage and clinical signs of CP in Italy and in Sweden. Infant's age range was 3–10 months. Normative data was collected from 492 typically developing infants. Results: The test items describe both unilateral and bilateral actions. After stepwise exclusion of items showing misfit to the Rasch model assertions, 17 items scored on a 3‐point rating scale was found to form a unidimensional construct. The HAI outcome is presented both for each hand separately, showing magnitude of asymmetry, as well as by a measure of bimanual hand use. Rasch analysis confirmed excellent internal construct validity; rating scale categories showed monotonically increasing step calibrations. Principal component analysis for the bimanual measure demonstrated unidimensionality by variance explained by measure 76.4% with variance explained by first contrast 4.8%. Item fit was demonstrated for ≥95% of items for all three subscales. Internal consistency ratios (reliability coefficients ≥0.80) was demonstrated for all three subscales.Tentative age norms were constructed. Conclusion: The HAI showed to be a promising tool for measuring hand function in infants with signs of unilateral CP, making it possible to detect and measure asymmetries, follow development over time and evaluate effects of early intervention on hand function.
The Hand Assessment for Infants (HAI): a new test for measuring asymmetries and use of hands in infants 3-10 months of age
Sgandurra G.;Guzzetta A;
2016-01-01
Abstract
Background: Asymmetric hand‐use is commonly the first clinical signs of unilateral cerebral palsy (CP) in infants, however, there is no assessment available which can detect and measure hand function in infants 3–10 months old. Aim: To describe the development of the Hand Assessment for Infants (HAI), the concept and construct and to report psychometric properties. Method: Test items were developed from literature review, expert groups and from systematic observations of goal‐directed hand/arm actions of infants. Internal scale validity was evaluated by Rasch measurement model analysis of 157 assessments of a clinical convenience sample of infants with a brain damage and clinical signs of CP in Italy and in Sweden. Infant's age range was 3–10 months. Normative data was collected from 492 typically developing infants. Results: The test items describe both unilateral and bilateral actions. After stepwise exclusion of items showing misfit to the Rasch model assertions, 17 items scored on a 3‐point rating scale was found to form a unidimensional construct. The HAI outcome is presented both for each hand separately, showing magnitude of asymmetry, as well as by a measure of bimanual hand use. Rasch analysis confirmed excellent internal construct validity; rating scale categories showed monotonically increasing step calibrations. Principal component analysis for the bimanual measure demonstrated unidimensionality by variance explained by measure 76.4% with variance explained by first contrast 4.8%. Item fit was demonstrated for ≥95% of items for all three subscales. Internal consistency ratios (reliability coefficients ≥0.80) was demonstrated for all three subscales.Tentative age norms were constructed. Conclusion: The HAI showed to be a promising tool for measuring hand function in infants with signs of unilateral CP, making it possible to detect and measure asymmetries, follow development over time and evaluate effects of early intervention on hand function.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
